Healthcare Provider Details

I. General information

NPI: 1356484182
Provider Name (Legal Business Name): JAMES UNTALAN HOFSCHNEIDER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COMMON WEALTH HEALTH CENTER LOWER NAVY HILL GARAPAN
SAIPAN MP
96960
UM

IV. Provider business mailing address

PO BOX 500589
SAIPAN MP
96950
US

V. Phone/Fax

Practice location:
  • Phone: 670-234-8950
  • Fax: 670-234-8930
Mailing address:
  • Phone: 670-234-8950
  • Fax: 670-234-8930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0017
License Number StateMP

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: